Peter L. Faries, MD, Nicholas Morrissey, MD, James A

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Internal iliac artery revascularization as an adjunct to endovascular repair of aortoiliac aneurysms Peter L. Faries, MD, Nicholas Morrissey, MD, James A. Burks, MD, Edwin Gravereaux, MD, Morris D. Kerstein, MD, Victoria J. Teodorescu, MD, Larry H. Hollier, MD, Michael L. Marin, MD Journal of Vascular Surgery Volume 34, Issue 5, Pages 892-899 (November 2001) DOI: 10.1067/mva.2001.118085 Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Schematic diagram of revascularization procedure. A, A bypass graft is constructed from the external iliac artery to the internal iliac artery using a 6-mm polyester graft. The internal iliac artery is ligated at its origin to prevent retrograde perfusion of the aneurysm. B, Alternatively, when sufficient redundancy is present, the internal iliac artery may be transected at its origin and anastomosed directly to the external iliac artery. Journal of Vascular Surgery 2001 34, 892-899DOI: (10.1067/mva.2001.118085) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Schematic diagram of retroinguinal dissection. The inguinal ligament is elevated and retracted superiorly. Dissection of the iliac vessels is carried out in the retroperitoneal space. Journal of Vascular Surgery 2001 34, 892-899DOI: (10.1067/mva.2001.118085) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Digital subtraction arteriogram of aortoiliac aneurysm. A, The patient experienced a previous dissection of the aorta extending from the aortic valve to the iliac bifurcation and underwent replacement of the entire thoracic aorta. Subsequent aneurismal degeneration of the infrarenal aorta occurred and endovascular repair with bilateral IIR was planned. B, Revascularization of the left internal iliac artery (I ) was performed using a 6-mm polyester graft (arrow ) from the external iliac artery (E ). C, Transposition of the internal iliac artery (I ) onto the external iliac artery (E ) was able to be performed on the right. Journal of Vascular Surgery 2001 34, 892-899DOI: (10.1067/mva.2001.118085) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 CT angiogram of aortoiliac aneurysm treated by using an endovascular graft in conjunction with right IIR. A, Arterial flow is seen within the bypass graft (arrow ). The bypass graft originates form the external iliac artery (E ). B, The internal iliac artery anastomosis (I ) and perfusion of the pelvic branches (arrow ) are seen. Journal of Vascular Surgery 2001 34, 892-899DOI: (10.1067/mva.2001.118085) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions